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Development of a Proof-of-Concept Multi-Method Computer Simulation to Support Rural Healthcare Disaster Preparedness Planning

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International Journal of Disaster Risk Science 2024年第3期15卷 346-358页

作者： Thomas A.Berg Kristina W.Kintziger Julie Suzuki Crumly Scott A.lawson Carole R.Myers Tracey T.Stansberry College of Nursing University of Tennessee Knoxville Department of environmental Agricultural and Occupational Health University of Nebraska Medical Center Public Health and Healthcare Oak Ridge Associated Universities

Due to a lack of resources, rural communities often face challenges when planning catastrophic events. This project involved applying systems thinking and model-based systems engineering to develop a proof-of-concept, multi-method computer simulation and then determining whether the simulation could be used to assess the efficacy of disaster planning approaches on health outcomes in rural communities, as a function of primary healthcare. The project focus was a rural or non-urban healthcare system experiencing a natural hazard. Both system dynamics and discrete event models were incorporated to represent subsystem operations, crucial disaster responses, as well as three key response systems: public health, emergency management, and healthcare. The subsystem models included several components: policies/procedures, communications,resources, exercises/drills/training, healthcare space and staff, and the flow of affected people into and through the *** combined simulation can serve as a first step to a more comprehensive approach to helping rural communities achieve more efficient and effective healthcare planning for disaster responses.

关键词： Computer simulation Disaster preparedness Model-based systems engineering Rural healthcare System dynamics model Systems thinking

Impact of COVID-19 on Safety Performance for Motorcycles: Pre-and during-Pandemic Conditions

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Journal of Transportation Technologies 2024年第3期14卷 390-401页

作者： Hongyun Chen Amelia lawson Charles Hurda Madalyn Smith Tate Grant Civil engineering Department Embry-Riddle Aeronautical University Daytona Beach FL USA

Florida has the highest number of motorcycle fatalities in the United States and contains the second largest population of registered motorcycles. The COVID-19 pandemic influenced the roads, traffic, and driving behavior in the continental United States. Motorcycle crashes decreased during the COVID-19 years (2020 and 2021) while the fatality rates increased. The purpose of this study is to 1) investigate motorcycle crashes before and during the Pandemic period to understand the impacts on motorcycle safety and contributing factors to the crash severity levels;2) develop the crash predictive model for different degrees of severity in motorcycle crashes in Florida. Florida statewide crash data were collected. T tests have been conducted to compare the contributing factors between two periods. The injury severities are significantly different among all five levels between those during normal period and the Pandemic period. A crash predictive model has been developed to determine the facts to injury severity levels for motorcycle crashes. A total of eight variables are found to significantly increase the injury severity levels for motorcycle crashes during the Pandemic period.

关键词： Motorcycle Crash Pandemic Injury Severity Contributing Factors

Optimization of Diesel and Crude Oil Degradation in a Ghanaian Soil Using Organic Wastes as Amendment

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Journal of Agricultural Chemistry and environment 2024年第1期13卷 1-12页

作者： Adama Sawadogo Innocent Yao Dotse lawson Hama Cissé Cheikna Zongo Aly Savadogo Laboratory of Applied Biochemistry and Immunology Research and Training Unit Life and Earth Sciences Joseph Ki-Zerbo University Ouagadougou Burkina Faso Soil Science Department School of Agriculture University of Ghana Accra Ghana

Soil contamination by hydrocarbons poses numerous environmental, health and agricultural problems. The degradation of these pollutants can occur naturally but very slowly. It is therefore generally necessary to stimulate this degradation by different means. Thus, this study aimed to improve the bio-degradation of diesel and crude oil in a Ghanaian soil by biostimulation. For this, the sampled soil was characterized by standard methods and contaminated with diesel and crude oil at a proportion of 1% (w/w). Then, contaminated soil samples were supplemented with biochar-compost, poultry manure or cow dung at the proportion of 10% (w/w). Periodically, fractions of these samples were taken to evaluate the density of hydrocarbon utilizing bacteria (HUB) and the residual quantities of diesel or crude oil. The characteristics of the soil used show the need for supplementation for better degradation of hydrocarbons. The results of the study show that supplementing the soil with organic substrates increases HUB loads in soils contaminated by diesel and crude oil. They also show that the residual quantities of diesel and crude oil are generally significantly lower in supplemented soils (p = 0.048 and p espectively). In addition, the study shows that degradation was generally greater in soils contaminated by diesel compared to those contaminated by crude oil, especially at the end of the study.

关键词： Biodegradation Biostimulation Soil Diesel Crude Oil Organic Amendment Ghana

Profile of Amoebic vs. Pyogenic Liver Abscess and Comparison of Demographical, Clinical, Radiological, and Laboratory Profiles of These Patients from Three Secondary Care Centers in Senegal

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Advances in Infectious Diseases 2024年第3期14卷 595-605页

作者： Agbogbenkou Tevi Dela-Dem lawson Daouda Thioub Ndiaga Mbengue Ndeye Amy Sarr Sylvie Audrey Diop Service des maladies Infectieuses et tropicales de lHpital de Tivaouane Tivaouane Sngal UFR des sciences de la sante de lUniversit Iba Der Thiam de This This Sngal

Background: Liver abscess (LA) is a suppurated collection in the hepatic parenchyma. In Africa, liver abscesses are most often of amoebic origin, but more recently, the rate of pyogenic liver abscesses (PLA) has increased. Objective: to assess the epidemiological characteristics, clinical features, biological radiological findings, and outcomes of patients with PLA and with amebic liver abscess (ALA) in order to determine the potential factors that may help improve diagnosis and treatment for LA in the context of secondary care centers with limited medical supports. Methods: Retrospective review of LA diagnosed and treated at three secondary care centers in Thiès over 11 years. Results: 61 patients, were included, 52.45% had ALA and 47.54% had PLA. Males were predominant (79.31% in PLA vs 65.63% in ALA, p = 0.2). The median age was 38 years for the PLA group vs 39 years for the ALA group (p = 0.4). In both groups, the most common symptom was right upper abdominal pain (81.97%), hepatomegaly (81.97%). The PLA group had a higher prevalence of fever (79.31% vs 46.88%, p = 0,009), chills (51.72% vs 18.75%, p = 0.007), right basi-thoracic pain (55.17% vs 28.13%, p = 0.032), and jaundice (55.17% vs 28%, p = 0.032). There was no difference in radiological features between PLA and ALA. Patients with PLA had a higher level of White blood cell (20.600 vs 15.400, p = 0.014). The most common bacteria identified in PLA were escherichia coli (58.8%). All patients had received antibiotic therapy, which was combined with aspiration puncture (37.3%), transcutaneous drainage (43.3%), and surgery (9.0%). Seven patients had received antibiotic therapy alone and all had amoebic abscesses. elsewhere, the occurrence of complications was higher in PLA cases (75.86% vs 37.5%, p = 0.003). The overall hospital mortality rate was 13.11%, higher in cases of PLA (24.14% vs 3.13%, p = 0.022). Conclusion: Clinical and biological features were more severe in PLA. But radiological features cannot be

关键词： Profile Liver Abscess Amoebic Pyogenic Senegal

Noninvasive Respiratory Strategies in Patients with Acute Hypoxemic Respiratory Failure and COVID-19 in Gabon: A Prospective Observational Study

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Open Journal of emergency Medicine 2024年第1期12卷 18-27页

作者： Ghislain edjo Nkilly Raphael Okoue Ondo Fernande Manga Stéphane Oliveira Jean Marcel Mandji-lawson Romain Tchoua Department of emergency Anesthesia Resuscitation Omar Bongo Ondimba Army Training Hospital Libreville Gabon Department of Anesthesia and Resuscitation Libreville University Hospital Center Libreville Gabon Department of Anesthesia and Resuscitation Akanda Army Training Hospital Libreville Gabon

Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO2/FiO2 ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanic

关键词： Respiratory Failure COVID 19-Intensive Care Units Military Hospital Gabon

Postoperative Analgesia and Cesarean Section under General Anesthesia: Multicenter Study

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Open Journal of Anesthesiology 2024年第1期14卷 1-12页

作者： Ghislain edjo Nkilly Raphael Okoue Ondo Pascal Christian Nze Obiang Stéphane Oliveira Jean-Marcel Mandji-lawson Romain Tchoua Department of Anesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon

Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4th post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia

关键词： Cesarean General Anesthesia Morphine Parietal Infiltration epidural Catheter Transversus Abdominis Plane Block Intravenous Analgesia

User-friendly finite element design of main entries, barrier pillars,and bleeder entries

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International Journal of Mining Science and Technology 2018年第1期28卷 3-10页

作者： william G.Pariseau Mark K.Larson Heather e.lawson Douglas R.Tesarik Department of Mining engineering University of Utah Spokane Mining Research Division NIOSH

This contribution describes development and application of a user-friendly finite element program,UT3PC, to address three important problems in underground coal mine design:(1) safety of main entries,(2) barrier pillar size needed for entry protection, and(3) safety of bleeder entries during the advance of an adjacent longwall *** the finite element method is by far the most popular engineering design tool of the digital age, widespread use by the mining community has been impeded by the relatively high cost of and the need for lengthy specialized training in numerical *** of UT3PC overcomes these impediments in three easy ***, a material properties file is prepared for the considered ***, mesh generation is automatic through an interactive process.A third and last step is simply execution of the *** using data from several western coal mines illustrate the ease of using the application for analysis of main entries, barrier pillars, and bleeder entry safety.

关键词： Finite element Coal Mine layout design Main entries Barrier pillars Bleeder entries

Intermediate Hip Arthroplasty in Gabon: Blood Loss and Risk Factor for Transfusion

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Open Journal of Anesthesiology 2024年第4期14卷 109-117页

作者： Ghislain edjo Nkilly Pascal Christian Nze Obiang Raphael Okoue Ondo Arthur Matsanga Stéphane Oliveira Léandre Nguiabanda Jean-Marcel Mandji-lawson Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic Surgery Service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.

关键词： Hip Arthroplasty Risk Factors Patients Hemiarthroplasty Gabon

exploration of petrographic,elemental,and material properties of dynamic failure-prone coals

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International Journal of Mining Science and Technology 2020年第1期30卷 69-75页

作者： Heather lawson Spokane Mining Research Division National Institute for Occupational Safety and HealthSpokaneWA 99207USA

The purpose of this study is to explore how the geochemical and petrographic components of coal may impact its physical properties and how these correlate with a history of reportable dynamic failure in coal *** failure events,also termed bumps,bounces,or bursts,are the explosive failures of rock in a mining *** events occur suddenly and often with no warning,resulting in worker injury up to and including fatality in greater than 60%of reportable cases through the Mine Safety and Health Administration(MSHA).A database of variables was compiled using publicly available datasets,which includes compositional geographic,strength,and Hardgrove grindability index(HGI)*** indicated that bumping coals were less mature,lower in carbon,higher in oxygen,softer,and less well cleated than coals that did not *** liptinite content was found to correlate with higher average uniaxial compressive strength(UCS)***,no clear and direct correlation between UCS and dynamic failure status was *** findings of this study established that differences existed between coals that had versus had not experienced reportable dynamic failure *** differences were inherent to the coal itself and were independent of mining-induced risk *** further illuminated how compositional attribute of coal influenced physical properties and began to clarify potential links between geochemistry and dynamic failure *** through the better understanding of risk can more effective mitigating strategies be enacted.

关键词： Dynamic failure Coal Bump Bounce Burst